Intraoperative disc level marking with needle: a technical note and prospective study on 30 patients.

Area of Science:

• Neurosurgery
• Spine Surgery
• Surgical Navigation

Background:

• Wrong-level surgery remains a significant risk in spine procedures, despite existing protocols.
• Minimally invasive techniques and advanced navigation aim to improve surgical accuracy and patient outcomes.
• Surgical navigation can enhance precision without increasing patient radiation exposure.

Purpose of the Study:

• To evaluate the efficacy of a percutaneous needle guidance technique for preventing wrong-level microdiscectomy.
• To assess the safety and feasibility of this novel landmarking method in lumbar disc herniation surgery.

Main Methods:

• A prospective study involving patients undergoing microdiscectomy for lumbar disc herniation.
• A percutaneous needle was placed under fluoroscopy at the target disc level as a surgical landmark.
• Data collected included patient demographics, pain scores (VAS), disability index (ODI), operative details, and radiation dose.

Main Results:

• Thirty patients were included; no wrong-level procedures occurred.
• Mean landmarking time was 2.22 minutes; average operative time was 54.5 minutes.
• Effective radiation dose was minimal (0.032 mSv), correlating with BMI and disc level.

Conclusions:

• Percutaneous needle guidance is an effective method to prevent wrong-level microdiscectomy.
• This technique functions as a navigation aid with negligible additional radiation for patients.
• The approach offers a safe and accurate solution for guiding spine surgery.